Figure 23 depicts the results of a meta-analysis for the comparison of intranasal corticosteroid plus nasal antihistamine versus intranasal corticosteroid. Four trials reported on the outcome of sneezing at two weeks. A random effects model using inverse variance weighting was used. Mean differences are reported for individual trials and for the overall pooled effect. In the first trial, Carr 1, 2012, there were 207 patients in the combination group and 207 patients in the intranasal corticosteroid group. The mean difference was 0.10 favoring combination treatment with a 95 percent confidence interval of -0.39 to 0.19. The weight of this trial was 24.3 percent. In the second trial, Carr 2, 2012, there were 193 patients in the combination group and 189 patients in the intranasal corticosteroid group. The mean difference was 0.30 favoring combination treatment with a 95 percent confidence interval of -0.61 to 0.01. The weight of this trial was 21.1 percent. In the third trial, Carr 3, 2012, there were 448 patients in the combination group and 450 patients in the intranasal corticosteroid group. The mean difference was 0.20 favoring combination treatment with a 95 percent confidence interval of -0.40 to 0.00. The weight of this trial was 49.5 percent. In the fourth trial, Ratner, 2008, there were 52 patients in the combination group and 49 patients in the intranasal corticosteroid group. The mean difference was 0.60 favoring combination treatment with a 95 percent confidence interval of -1.22 to 0.02. The weight of this trial was 5.2 percent. The overall result included 900 patients in the combination group and 895 patients in the intranasal corticosteroid group. The overall pooled mean difference was 0.22 favoring combination treatment with a 95 percent confidence interval of -0.36 to -0.07. The figure shows a forest plot of these results. The x-axis spans minus 1 at the left favoring intranasal corticosteroid plus nasal antihistamine to positive 1 at the right favoring intranasal corticosteroid. There is a vertical line at zero that that extends up from the x-axis. The mean difference for each trial is represented by a green box sized according to the weight of the trial. The confidence interval is represented by a horizontal black line centered on the box. The overall pooled result is represented by a black diamond, the ends of which represent the confidence interval for the pooled result. The green boxes for two trials fall to the left of the vertical line. The right edge of the green boxes for the first trial, Carr 1, 2012, and for the third trial, Carr, 3, 2012, appear to fall on the vertical line. The black diamond falls to the left of the vertical line. Tests for heterogeneity are Tau squared of 0.00, chi squared of 2.37 with 3 degrees of freedom and a p-value of 0.50, and I squared of zero percent. The Z test for overall effect was 2.99 with a p-value of 0.003.

Figure 23Sneezing at 2 weeks meta-analysis: combination intranasal corticosteroid plus nasal antihistamine versus intranasal corticosteroid

From: Results

Cover of Treatments for Seasonal Allergic Rhinitis
Treatments for Seasonal Allergic Rhinitis [Internet].
Comparative Effectiveness Reviews, No. 120.
Glacy J, Putnam K, Godfrey S, et al.

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